Brant Wahlen Fonnesbeck, DO - Medicare Family Practice in Logan, UT

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Brant Wahlen Fonnesbeck, DO is a medicare enrolled "Family Medicine" physician in Logan, Utah. He went to At Still University Of Health Sciences, College Of Osteo Med, Kirksville and graduated in 2004 and has 20 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Intermountain Healthcare Services, Inc and his current practice location is 550 E 1400 N Ste K, Logan, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 755-6061.

Brant Wahlen Fonnesbeck is licensed to practice in Utah (license number 5953772-1204) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1033156849.

Contact Information

Brant Wahlen Fonnesbeck, DO
550 E 1400 N Ste K,
Logan, UT 84341-2450
(435) 755-6061
Not Available

Map and Direction




Physician's Profile

Full NameBrant Wahlen Fonnesbeck
GenderMale
SpecialityFamily Practice
Experience20 Years
Location550 E 1400 N Ste K, Logan, Utah
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Brant Wahlen Fonnesbeck attended and graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2004
  NPI Data:
  • NPI Number: 1033156849
  • Provider Enumeration Date: 06/01/2006
  • Last Update Date: 02/26/2008
  Medicare PECOS Information:
  • PECOS PAC ID: 3274558564
  • Enrollment ID: I20051005001126

Medical Identifiers

Medical identifiers for Brant Wahlen Fonnesbeck such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033156849NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 5953772-1204 (Utah)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Intermountain Healthcare Services, Inc18502094203228

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brant Wahlen Fonnesbeck allows following entities to bill medicare on his behalf.
Entity NameIhc Health Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629260880
PECOS PAC ID: 1850209420
Enrollment ID: O20031105000079
Entity NameIhc Health Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942325154
PECOS PAC ID: 1850209420
Enrollment ID: O20080610000303
Entity NameHc Healthcare, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184271215
PECOS PAC ID: 1153755384
Enrollment ID: O20191223000550

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brant Wahlen Fonnesbeck is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Brant Wahlen Fonnesbeck, DO
325 W Logan Hwy, Po Box 328,
Garden City, UT 84028

Ph: (435) 764-7249		Brant Wahlen Fonnesbeck, DO
550 E 1400 N Ste K,
Logan, UT 84341-2450

Ph: (435) 755-6061

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.